A MODIFICATION OF THE TRANSCORONAL FLAP THAT ENHANCES ORBITAL EXPOSURE AND COSMESIS

The transcoronal surgical approach for the treatment of orbital diseas e has become increasingly popular since it affords excellent surgical exposure through a cosmetically acceptable incision. Exposure of the i nferior orbit, however, can be difficult due to limited flap mobility in the frontal plane. Increased inferior exposure may be obtained by e xtending the incision inferiorly in preauricular skin. In children and young adults without excess preauricular skin folds or wrinkling, how ever, the wound may be quite apparent, compromising cosmesis. To overc ome this drawback, we demonstrate a modified transcoronal incision tha t redirects the inferior limbs into the postauricular sulcus. This inc ision not only results in superior cosmesis, but avoids important prea uricular neurovascular structures and enhances orbital exposure.